Control strategies for lymphatic filariasis and pneumonia MCQs With Answer

Introduction: Control strategies for lymphatic filariasis and pneumonia integrate public health, pharmacology, and clinical care to reduce disease burden. For B. Pharm students, understanding mass drug administration, preventive chemotherapy (albendazole, ivermectin, diethylcarbamazine), vector control, morbidity management, antibiotics for pneumonia, vaccination (pneumococcal, Hib), diagnostics, and surveillance is essential. Knowledge of drug mechanisms, dosing, contraindications, resistance, and community-based interventions prepares pharmacists for roles in program implementation and pharmacovigilance. This topic links parasitology, respiratory infections, and rational therapeutics to real-world public health outcomes. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which drug combination is commonly used in mass drug administration (MDA) programs for lymphatic filariasis in many endemic countries?

• Albendazole plus azithromycin
• Albendazole plus ivermectin
• Albendazole plus oseltamivir
• Albendazole plus isoniazid

Correct Answer: Albendazole plus ivermectin

Q2. The primary target of antifilarial drugs like diethylcarbamazine (DEC) is:

• Adult worms only (macrofilariae)
• Microfilariae in the bloodstream
• Bacterial Wolbachia exclusively
• Filarial egg stages in tissues

Correct Answer: Microfilariae in the bloodstream

Q3. For community control of lymphatic filariasis, vector control focuses mainly on which mosquito genus in urban settings?

• Anopheles
• Aedes
• Culex
• Mansonia

Correct Answer: Culex

Q4. Which diagnostic test detects circulating filarial antigen and is useful for mapping lymphatic filariasis?

• Blood smear for microfilariae at night
• IgM serology for filarial antibodies
• Circulating filarial antigen (CFA) rapid test
• Skin snip biopsy

Correct Answer: Circulating filarial antigen (CFA) rapid test

Q5. A major contraindication for ivermectin in MDA is:

• Children under 5 years of age or <15 kg
• Pregnancy after first trimester
• Patients with hypertension
• Concurrent use of albendazole

Correct Answer: Children under 5 years of age or <15 kg

Q6. In lymphatic filariasis morbidity management, the first-line strategy to prevent acute attacks in lymphedema is:

• Systemic corticosteroids
• Regular hygiene and limb care
• Daily diethylcarbamazine
• Immediate hydrocele surgery

Correct Answer: Regular hygiene and limb care

Q7. Which bacterial pathogen is most commonly associated with community-acquired pneumonia in adults worldwide?

• Haemophilus influenzae type b
• Streptococcus pneumoniae
• Mycobacterium tuberculosis
• Staphylococcus aureus

Correct Answer: Streptococcus pneumoniae

Q8. First-line oral antibiotic recommended by WHO for non-severe pneumonia in children is:

• Oral amoxicillin
• Oral ciprofloxacin
• Oral azithromycin long-course
• Oral vancomycin

Correct Answer: Oral amoxicillin

Q9. Pneumococcal conjugate vaccines (PCV) reduce pneumonia by primarily targeting:

• All bacterial causes of pneumonia
• Specific capsular serotypes of Streptococcus pneumoniae
• Viral respiratory pathogens
• Mycoplasma species

Correct Answer: Specific capsular serotypes of Streptococcus pneumoniae

Q10. In severe pneumonia with hypoxia, immediate pharmacologic priority is:

• High-dose oral vitamin A
• Administration of parenteral antibiotics and oxygen therapy
• Initiation of corticosteroids only
• Oral rehydration solution

Correct Answer: Administration of parenteral antibiotics and oxygen therapy

Q11. Which intervention is critical to minimize antifilarial drug adverse effects due to high microfilarial loads?

• Pre-treatment with antihistamines only
• Screening for heavy infections and supervised dosing
• Using monotherapy with albendazole always
• Avoiding all MDA in endemic areas

Correct Answer: Screening for heavy infections and supervised dosing

Q12. Wolbachia-targeting antibiotics (e.g., doxycycline) help control filariasis by:

• Rapid killing of microfilariae within hours
• Sterilizing adult worms by eliminating symbiotic bacteria
• Acting as a vector larvicide
• Enhancing mosquito immunity against parasites

Correct Answer: Sterilizing adult worms by eliminating symbiotic bacteria

Q13. Which pharmacologic property is important when selecting antibiotics for community-acquired pneumonia with suspected intracellular pathogens?

• Poor intracellular penetration
• Good lung tissue and intracellular penetration
• Exclusive renal excretion
• Only topical activity

Correct Answer: Good lung tissue and intracellular penetration

Q14. A public health indicator used to monitor lymphatic filariasis elimination progress is:

• Number of pneumonia cases per year
• Transmission Assessment Survey (TAS) results
• Incidence of malaria
• Rates of tuberculosis diagnosis

Correct Answer: Transmission Assessment Survey (TAS) results

Q15. Which adverse effect is most associated with diethylcarbamazine (DEC) during treatment of filariasis?

• Nephrotoxicity leading to renal failure
• Mazzotti-like reactions due to microfilarial killing
• Severe QT prolongation universally
• Irreversible hearing loss

Correct Answer: Mazzotti-like reactions due to microfilarial killing

Q16. In pneumonia management, the CURB-65 score helps clinicians decide:

• Which antibiotic class to choose based on culture
• Need for hospitalization versus outpatient care
• Duration of antiviral therapy
• Appropriate vaccine schedule

Correct Answer: Need for hospitalization versus outpatient care

Q17. Which is a key pharmacovigilance concern during MDA for lymphatic filariasis?

• Lack of cold chain for albendazole
• Monitoring and reporting of adverse drug reactions in communities
• Ensuring daily dosing for one month
• Reducing oxygen use in hospitals

Correct Answer: Monitoring and reporting of adverse drug reactions in communities

Q18. In infants, the Hib vaccine primarily prevents pneumonia by protecting against:

• Viral bronchiolitis
• Haemophilus influenzae type b bacterial infection
• Pneumocystis jirovecii
• Atypical mycobacterial disease

Correct Answer: Haemophilus influenzae type b bacterial infection

Q19. Which drug interaction is important to consider when co-administering albendazole with certain antiepileptic drugs?

• Antiepileptics increase albendazole levels by inhibiting metabolism
• Some antiepileptics (e.g., carbamazepine) induce metabolism and reduce albendazole efficacy
• There are no known interactions
• Antiepileptics convert albendazole to an active antiviral

Correct Answer: Some antiepileptics (e.g., carbamazepine) induce metabolism and reduce albendazole efficacy

Q20. In areas co-endemic for Loa loa, MDA with ivermectin may be risky because:

• Ivermectin has no activity against Loa loa
• High Loa loa microfilarial loads can cause severe encephalopathy after ivermectin
• Loa loa increases drug absorption leading to toxicity
• Ivermectin enhances Loa loa transmission

Correct Answer: High Loa loa microfilarial loads can cause severe encephalopathy after ivermectin

Q21. For bacterial pneumonia, empirical therapy should be guided by:

• Local antimicrobial resistance patterns and patient factors
• Only global guidelines regardless of location
• Patient preference for pill color
• Exclusive reliance on viral PCR

Correct Answer: Local antimicrobial resistance patterns and patient factors

Q22. Which community strategy reduces both filariasis transmission and mosquito-borne viral diseases?

• Exclusive use of antibiotics in communities
• Integrated vector management including environmental sanitation and bed nets
• Mass vaccination against filarial worms
• Daily vitamin supplementation

Correct Answer: Integrated vector management including environmental sanitation and bed nets

Q23. A pharmacist’s role in pneumonia control programs includes:

• Only dispensing medications without counseling
• Ensuring appropriate antibiotic selection, dosing, adherence counseling, and reporting resistance
• Performing chest physiotherapy
• Prescribing surgical interventions

Correct Answer: Ensuring appropriate antibiotic selection, dosing, adherence counseling, and reporting resistance

Q24. Which laboratory finding is most specific for active filarial infection?

• Elevated CRP only
• Detection of microfilariae on peripheral blood smear or positive CFA
• High eosinophil count with negative antigen tests
• Positive sputum Gram stain

Correct Answer: Detection of microfilariae on peripheral blood smear or positive CFA

Q25. In hospitalized adults with suspected pneumococcal pneumonia and penicillin allergy, an alternative antibiotic class is:

• Carbapenems routinely
• Macrolides or respiratory fluoroquinolones depending on severity and resistance
• Aminoglycosides as monotherapy
• Topical antiseptics

Correct Answer: Macrolides or respiratory fluoroquinolones depending on severity and resistance

Q26. Which preventive chemotherapy schedule is recommended by WHO for annual MDA in many endemic areas?

• Daily albendazole for 6 months
• Single annual dose of albendazole combined with DEC or ivermectin where appropriate
• Monthly ivermectin injections for a year
• Weekly DEC prophylaxis indefinitely

Correct Answer: Single annual dose of albendazole combined with DEC or ivermectin where appropriate

Q27. A common cause of treatment failure in childhood pneumonia programs is:

• Excessive adherence to therapy
• Poor adherence to antibiotic regimens and delays in care-seeking
• Universal vaccination coverage
• Overuse of bed nets

Correct Answer: Poor adherence to antibiotic regimens and delays in care-seeking

Q28. Which monitoring activity strengthens both lymphatic filariasis and pneumonia control programs?

• Regular community-based surveys for infection prevalence and vaccine coverage
• Eliminating all antibiotics from formularies
• Stopping all surveillance after one year
• Only monitoring hospital bed occupancy

Correct Answer: Regular community-based surveys for infection prevalence and vaccine coverage

Q29. When integrating filariasis MDA with other public health programs, a pharmacist should prioritize:

• Maximizing tablet color variety
• Coordinating drug safety messages, supply-chain logistics, and training community distributors
• Reducing the number of healthcare workers
• Replacing all vaccines with MDA

Correct Answer: Coordinating drug safety messages, supply-chain logistics, and training community distributors

Q30. In managing severe pediatric pneumonia, which is a key supportive therapy besides antibiotics?

• High-flow oxygen and fluid management as indicated
• Routine use of broad-spectrum antifungals
• Immediate surgical drainage
• Topical nasal decongestants only

Correct Answer: High-flow oxygen and fluid management as indicated

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